Provider Demographics
NPI:1033461348
Name:SORRENTI, ATHERTON L (DC)
Entity Type:Individual
Prefix:DR
First Name:ATHERTON
Middle Name:L
Last Name:SORRENTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12264 EL CAMINO REAL
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3060
Mailing Address - Country:US
Mailing Address - Phone:858-481-0303
Mailing Address - Fax:858-481-9797
Practice Address - Street 1:12264 EL CAMINO REAL
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3060
Practice Address - Country:US
Practice Address - Phone:858-481-0303
Practice Address - Fax:858-481-9797
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32499111NP0017X
TX11972111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation